Healthcare Provider Details

I. General information

NPI: 1558566984
Provider Name (Legal Business Name): HAROLD A YOON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2007
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W MCKINLEY AVE STE 1
DECATUR IL
62526-5858
US

IV. Provider business mailing address

210 W MCKINLEY AVE STE 1
DECATUR IL
62526-5858
US

V. Phone/Fax

Practice location:
  • Phone: 217-877-9442
  • Fax: 217-233-1670
Mailing address:
  • Phone: 217-877-9442
  • Fax: 217-233-1670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number036119960
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: